The benefits of six-sigma quality standard implementation are realized by the manufacturing sector very well and most of the cases reaped astounding benefits. This paper presents an extensive review on the services, six-sigma, and study the Critical Success Factors, Critical to Quality Characteristics and Key Performance Indicators in medium scale hospitals in Tamilnadu, India. Can health care approach the near perfection of Six Sigma in actual practice? . General Electric has begun to apply the same Six Sigma methods that worked to improve its manufacturing processes to its other, more service-oriented businesses. We believe, however, that asking this question must not be an excuse for failing to embark on the journey. Health care now frequently produces defects at rates as high as 500,000 per million––as exemplified in failures to recognize and treat clinical depression (Wells et al. 1989) or control hypertension (Udvarhelyi et al. 1991). Enough examples of improvement exist to conclude that we can do much better. In order to improve health service quality focus on health service process is necessary. Six-sigma is a philosophy which also concentrates on the improvement of process. So, six-sigma if properly applied can be useful for health services. The wider applicability of six-sigma depends on identification of key performance indicators (KPIs) for different types of health service processes. A case study is conducted in a medium scale hospital to identify, analyze and rank the critical success factors for Six sigma implementation available in literature, critical to quality characteristics (CTQs) ,KPIs and hurdles in the hospitals which affect possible quality improvements. This study will be helpful to both practitioners and researchers.

Key words : Health Services, Six-Sigma, Critical success factors, Key Performance Indicators, CTQs